NPIMap

Organization Active NPI

Walgreens

  • Community/Retail Pharmacy
  • Lake Wales, FL
National Provider Identifier
1619258209
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PS44826 Issued in FL
Legal business name
WALGREENS
Practice address
1903 State Road 60 E
Lake Wales, FL 33853-4329
Phone
(863) 676-9496
NPI assigned
Sep 8, 2011
Last updated
Sep 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John RothNPI 1447520945
Title
Pharmacy Manager
Phone
(863) 676-9496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PS44826 FL Primary

Addresses

Primary practice location

1903 State Road 60 E
Lake Wales, FL 33853-4329

Mailing address

1903 State Road 60 E
Lake Wales, FL 33853-4329
Phone (863) 676-9496

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1619258209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534329",
            "telephone_number": "863-676-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534329",
            "telephone_number": "863-676-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "863-676-9496"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS44826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.